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Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients

BACKGROUND: We investigated a large population of patients with chronic obstructive pulmonary disease (COPD) to determine their frequency of medication use and patterns of pharmacotherapy. METHODS: Medical and pharmacy claims data were retrospectively analyzed from 19 health plans (>7.79 million...

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Autores principales: Make, Barry, Dutro, Michael P, Paulose-Ram, Ryne, Marton, Jenö P, Mapel, Douglas W
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273365/
https://www.ncbi.nlm.nih.gov/pubmed/22315517
http://dx.doi.org/10.2147/COPD.S27032
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author Make, Barry
Dutro, Michael P
Paulose-Ram, Ryne
Marton, Jenö P
Mapel, Douglas W
author_facet Make, Barry
Dutro, Michael P
Paulose-Ram, Ryne
Marton, Jenö P
Mapel, Douglas W
author_sort Make, Barry
collection PubMed
description BACKGROUND: We investigated a large population of patients with chronic obstructive pulmonary disease (COPD) to determine their frequency of medication use and patterns of pharmacotherapy. METHODS: Medical and pharmacy claims data were retrospectively analyzed from 19 health plans (>7.79 million members) across the US. Eligible patients were aged ≥40 years, continuously enrolled during July 2004 to June 2005, and had at least one inpatient or at least two outpatient claims coded for COPD. As a surrogate for severity of illness, COPD patients were stratified by complexity of illness using predefined International Classification of Diseases, Ninth Revision, Clinical Modification, Current Procedural Terminology, Fourth Edition, and Healthcare Common Procedure Coding System codes. RESULTS: A total of 42,565 patients with commercial insurance and 8507 Medicare patients were identified. Their mean age was 54.7 years and 74.8 years, and 48.7% and 46.9% were male, respectively. In total, 66.3% of commercial patients (n = 28,206) were not prescribed any maintenance COPD pharmacotherapy (59.1% no medication; 7.2% inhaled short-acting β2-agonist only). In the Medicare population, 70.9% (n = 6031) were not prescribed any maintenance COPD pharmacotherapy (66.0% no medication; 4.9% short-acting β2-agonist only). A subset of patients classified as high-complexity were similarly undertreated, with 58.7% (5358/9121) of commercial and 68.8% (1616/2350) of Medicare patients not prescribed maintenance COPD pharmacotherapy. Only 18.0% and 9.8% of diagnosed smokers in the commercial and Medicare cohorts had a claim for a smoking cessation intervention and just 16.6% and 23.5%, respectively, had claims for an influenza vaccination. CONCLUSION: This study highlights a high degree of undertreatment of COPD in both commercial and Medicare patients, with most patients receiving no maintenance pharmacotherapy or influenza vaccination.
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spelling pubmed-32733652012-02-07 Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients Make, Barry Dutro, Michael P Paulose-Ram, Ryne Marton, Jenö P Mapel, Douglas W Int J Chron Obstruct Pulmon Dis Original Research BACKGROUND: We investigated a large population of patients with chronic obstructive pulmonary disease (COPD) to determine their frequency of medication use and patterns of pharmacotherapy. METHODS: Medical and pharmacy claims data were retrospectively analyzed from 19 health plans (>7.79 million members) across the US. Eligible patients were aged ≥40 years, continuously enrolled during July 2004 to June 2005, and had at least one inpatient or at least two outpatient claims coded for COPD. As a surrogate for severity of illness, COPD patients were stratified by complexity of illness using predefined International Classification of Diseases, Ninth Revision, Clinical Modification, Current Procedural Terminology, Fourth Edition, and Healthcare Common Procedure Coding System codes. RESULTS: A total of 42,565 patients with commercial insurance and 8507 Medicare patients were identified. Their mean age was 54.7 years and 74.8 years, and 48.7% and 46.9% were male, respectively. In total, 66.3% of commercial patients (n = 28,206) were not prescribed any maintenance COPD pharmacotherapy (59.1% no medication; 7.2% inhaled short-acting β2-agonist only). In the Medicare population, 70.9% (n = 6031) were not prescribed any maintenance COPD pharmacotherapy (66.0% no medication; 4.9% short-acting β2-agonist only). A subset of patients classified as high-complexity were similarly undertreated, with 58.7% (5358/9121) of commercial and 68.8% (1616/2350) of Medicare patients not prescribed maintenance COPD pharmacotherapy. Only 18.0% and 9.8% of diagnosed smokers in the commercial and Medicare cohorts had a claim for a smoking cessation intervention and just 16.6% and 23.5%, respectively, had claims for an influenza vaccination. CONCLUSION: This study highlights a high degree of undertreatment of COPD in both commercial and Medicare patients, with most patients receiving no maintenance pharmacotherapy or influenza vaccination. Dove Medical Press 2012 2012-01-18 /pmc/articles/PMC3273365/ /pubmed/22315517 http://dx.doi.org/10.2147/COPD.S27032 Text en © 2012 Make et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Original Research
Make, Barry
Dutro, Michael P
Paulose-Ram, Ryne
Marton, Jenö P
Mapel, Douglas W
Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients
title Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients
title_full Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients
title_fullStr Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients
title_full_unstemmed Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients
title_short Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients
title_sort undertreatment of copd: a retrospective analysis of us managed care and medicare patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273365/
https://www.ncbi.nlm.nih.gov/pubmed/22315517
http://dx.doi.org/10.2147/COPD.S27032
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